by Elizabeth Hofheinz, M.P.H., M.Ed., November 6, 2019
There’s nothing that says, “Power to the People” like the chance to speak ill of a physician in the online universe.
“I am keeping an eye on this trend of rating physicians online,” notes one spine surgeon. “While certainly useful for selecting a restaurant or hotel, these sites are giving carte blanche to disgruntled patients, who may or may not have a legitimate complaint about a doctor.”
“These ratings are now a regular part of medicine and at some institutions online complaints have risen to actionable issues. Because reimbursement is tied to patient comments/satisfaction and because hospitals fear that their brand will be negatively affected, they feel the need to take some sort of action toward the physician. There are serious concerns about where this will lead in the future, and future actions in the next 2-5 years.”
“It is worrisome because I have seen faculty members at other institutions become punished and sent to remedial counseling because of poor patient evaluations. And while we all understand how subjective these ratings are, they must still be taken seriously.”
“This really affects our pain management colleagues because they have so many patients asking for opioids…and with the host of new rules about these medications, physicians have to cut back on prescribing them. There are actually patients who have told their physicians, ‘Hey if I don’t get an opioid today, I will give you a poor online review.’”
There’s the door, doc.
Our anonymous surgeon says, “I know one surgeon who was even put on leave and required to attend counseling sessions due to his patient satisfaction ratings. Some institutions are equating a certain number of negative reviews with poor performance or behavior say, ‘Dr. X, you need counseling in order to ensure that you are dealing with patients in the right way.’ Some facilities are even making physicians undergo drug testing. I am seeing that state institutions in particular take things to the extreme.”
“This guy is a criminal!”
“An appropriately-conducted evaluation can be a healthy measure and can instruct people on areas where they can improve. But when patients ‘let loose’ on the internet you have no control and they have no filter. Another piece of the picture is that institutions are so afraid of paying penalties to Medicare that if they determine that satisfaction scores are not high enough then they may act hastily to intervene. They see a comment online such as, ‘This guy is a criminal’ and they panic.”
“There should be a more reasonable, rule-based way to handle this. Maybe there should be a standardized review form where checking boxes ‘yes’ or ‘no’ is the only option. What is lacking is context. It would be nice if the hospital could say, ‘Dr. X only had a bad review because—to be fair—that person was a chronic pain patient who had been on narcotics for 20 years. When we investigated the online comments, it turned out that this patient was looking for opioids and the doctor refused to prescribe them.”
“If these ratings are all that people are relying on then, the appropriate context should be provided. It is unclear what societies or professional societies would be able to do about these issues. Perhaps, making comments personalized and not allowing anonymous comments would be appropriate? Often, these negative comments could create a pre-conceived bias towards that physician. This could have negative effects later, if there should be an unavoidable complex situation or complication, which could be judged unfairly due to these pre-conceived perceptions.”
